TY - JOUR
T1 - Gait turning patterns in chronic ischemic stroke males and its relationship to recovery
T2 - A cross-sectional study
AU - Kusumaningsih, Widjajalaksmi
AU - Triangto, Kevin
AU - Salim, Harris
AU - Benlidayi, Ilke Coskun
N1 - Funding Information:
This study is funded through Hibah PITTA UI 2018 provided by Universitas Indonesia (Award ID: 18-07-18), granted to Widjajalaksmi Kusumaningsih.
Publisher Copyright:
© 2019 the Author(s). Published by Wolters Kluwer Health, Inc.
PY - 2019/9/1
Y1 - 2019/9/1
N2 - Introduction:Impaired turning patterns have been considered as 1 factor which potentially leads to disability in chronic stroke patients. Mobility comprises 80% of the chief disability, and would eventually lead to falls. Expanded Timed Up and Go (ETUG) is an effective mobility assessment method. It utilizes video recording to analyze the conventional Time Up and Go (TUG) Test components, which includes turning pattern analysis.Methods:Six healthy males without stroke history and 21 chronic ischemic stroke males (divided into subjects with or without the presence of flexor synergy pattern subgroups) capable of independent ambulation were recruited from Neurology and Medical Rehabilitation Department outpatient clinic. ETUG tests were recorded for each subject and were analyzed thoroughly using a computer program.Results:Timed Up and Go time was significantly different between the 3 groups (P=.001). As compared to control, and synergy absent group, median turning time was highest in chronic stroke patients with presence of flexor synergy by 2786 ms (P=.002), but was not significantly different in percentage ETUG (14%, P=.939). Further analysis revealed that Brunnstrom stage and number of steps taken for turning significantly affect TUG duration. Other factors such as hemiparetic side, or body height were not significantly associated.Discussion:The presence of flexor synergy would significantly affect turning time, this would then correlate to the disability of shifting body's center of gravity, as a part of the Stroke core set of International Classification of Functioning, Disability, and Health (ICF).Therefore, stroke patients need to have early ambulatory training regarding pivoting motion rather than solely focusing on straight walking. Instead of hemiparetic side, it is possible that overall turning time is affected by coordination and orientation capability, signifying the importance of cortical plasticity.
AB - Introduction:Impaired turning patterns have been considered as 1 factor which potentially leads to disability in chronic stroke patients. Mobility comprises 80% of the chief disability, and would eventually lead to falls. Expanded Timed Up and Go (ETUG) is an effective mobility assessment method. It utilizes video recording to analyze the conventional Time Up and Go (TUG) Test components, which includes turning pattern analysis.Methods:Six healthy males without stroke history and 21 chronic ischemic stroke males (divided into subjects with or without the presence of flexor synergy pattern subgroups) capable of independent ambulation were recruited from Neurology and Medical Rehabilitation Department outpatient clinic. ETUG tests were recorded for each subject and were analyzed thoroughly using a computer program.Results:Timed Up and Go time was significantly different between the 3 groups (P=.001). As compared to control, and synergy absent group, median turning time was highest in chronic stroke patients with presence of flexor synergy by 2786 ms (P=.002), but was not significantly different in percentage ETUG (14%, P=.939). Further analysis revealed that Brunnstrom stage and number of steps taken for turning significantly affect TUG duration. Other factors such as hemiparetic side, or body height were not significantly associated.Discussion:The presence of flexor synergy would significantly affect turning time, this would then correlate to the disability of shifting body's center of gravity, as a part of the Stroke core set of International Classification of Functioning, Disability, and Health (ICF).Therefore, stroke patients need to have early ambulatory training regarding pivoting motion rather than solely focusing on straight walking. Instead of hemiparetic side, it is possible that overall turning time is affected by coordination and orientation capability, signifying the importance of cortical plasticity.
KW - chronic ischemic stroke
KW - neuroplasticity
KW - synergy presence
KW - timed up and go
KW - turning
UR - http://www.scopus.com/inward/record.url?scp=85072784060&partnerID=8YFLogxK
U2 - 10.1097/MD.0000000000017210
DO - 10.1097/MD.0000000000017210
M3 - Article
C2 - 31567973
AN - SCOPUS:85072784060
SN - 0025-7974
VL - 98
JO - Medicine (United States)
JF - Medicine (United States)
IS - 38
M1 - e17210
ER -